Tags

Type your tag names separated by a space and hit enter

30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: A prospective cohort study.
Pharmacol Res. 2020 08; 158:104931.PR

Abstract

Italy was the first European country hit by the COVID-19 pandemic and has the highest number of recorded COVID-19 deaths in Europe. This prospective cohort study of the correlates of the risk of death in COVID-19 patients was conducted at the Infectious Diseases and Intensive Care units of Luigi Sacco Hospital, Milan, Italy. The clinical characteristics of all the COVID-19 patients hospitalised in the early days of the epidemic (21 February -19 March 2020) were recorded upon admission, and the time-dependent probability of death was evaluated using the Kaplan-Meier method (censored as of 20 April 2020). Cox proportional hazard models were used to assess the factors independently associated with the risk of death. Forty-eight (20.6 %) of the 233 patients followed up for a median of 40 days (interquartile range 33-47) died during the follow-up. Most were males (69.1 %) and their median age was 61 years (IQR 50-72). The time-dependent probability of death was 19.7 % (95 % CI 14.6-24.9 %) 30 days after hospital admission. Age (adjusted hazard ratio [aHR] 2.08, 95 % CI 1.48-2.92 per ten years more) and obesity (aHR 3.04, 95 % CI 1.42-6.49) were independently associated with an increased risk of death, which was also associated with critical disease (aHR 8.26, 95 % CI 1.41-48.29), C-reactive protein levels (aHR 1.17, 95 % CI 1.02-1.35 per 50 mg/L more) and creatinine kinase levels above 185 U/L (aHR 2.58, 95 % CI 1.37-4.87) upon admission. Case-fatality rate of patients hospitalized with COVID-19 in the early days of the Italian epidemic was about 20 %. Our study adds evidence to the notion that older age, obesity and more advanced illness are factors associated to an increased risk of death among patients hospitalized with COVID-19.

Authors+Show Affiliations

Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy. Electronic address: andrea.giacomelli@unimi.it.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.Department of Internal Medicine, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, Milan, Italy.Department of Emergency Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy.Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, Milan, Italy.Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, Milan, Italy.Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Italy.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32446978

Citation

Giacomelli, Andrea, et al. "30-day Mortality in Patients Hospitalized With COVID-19 During the First Wave of the Italian Epidemic: a Prospective Cohort Study." Pharmacological Research, vol. 158, 2020, p. 104931.
Giacomelli A, Ridolfo AL, Milazzo L, et al. 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: A prospective cohort study. Pharmacol Res. 2020;158:104931.
Giacomelli, A., Ridolfo, A. L., Milazzo, L., Oreni, L., Bernacchia, D., Siano, M., Bonazzetti, C., Covizzi, A., Schiuma, M., Passerini, M., Piscaglia, M., Coen, M., Gubertini, G., Rizzardini, G., Cogliati, C., Brambilla, A. M., Colombo, R., Castelli, A., Rech, R., ... Galli, M. (2020). 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: A prospective cohort study. Pharmacological Research, 158, 104931. https://doi.org/10.1016/j.phrs.2020.104931
Giacomelli A, et al. 30-day Mortality in Patients Hospitalized With COVID-19 During the First Wave of the Italian Epidemic: a Prospective Cohort Study. Pharmacol Res. 2020;158:104931. PubMed PMID: 32446978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: A prospective cohort study. AU - Giacomelli,Andrea, AU - Ridolfo,Anna Lisa, AU - Milazzo,Laura, AU - Oreni,Letizia, AU - Bernacchia,Dario, AU - Siano,Matteo, AU - Bonazzetti,Cecilia, AU - Covizzi,Alice, AU - Schiuma,Marco, AU - Passerini,Matteo, AU - Piscaglia,Marco, AU - Coen,Massimo, AU - Gubertini,Guido, AU - Rizzardini,Giuliano, AU - Cogliati,Chiara, AU - Brambilla,Anna Maria, AU - Colombo,Riccardo, AU - Castelli,Antonio, AU - Rech,Roberto, AU - Riva,Agostino, AU - Torre,Alessandro, AU - Meroni,Luca, AU - Rusconi,Stefano, AU - Antinori,Spinello, AU - Galli,Massimo, Y1 - 2020/05/22/ PY - 2020/05/11/received PY - 2020/05/13/accepted PY - 2020/5/25/pubmed PY - 2020/7/21/medline PY - 2020/5/25/entrez KW - 30-day mortality KW - Advanced age KW - Italy KW - Obesity KW - SARS-CoV-2 SP - 104931 EP - 104931 JF - Pharmacological research JO - Pharmacol Res VL - 158 N2 - Italy was the first European country hit by the COVID-19 pandemic and has the highest number of recorded COVID-19 deaths in Europe. This prospective cohort study of the correlates of the risk of death in COVID-19 patients was conducted at the Infectious Diseases and Intensive Care units of Luigi Sacco Hospital, Milan, Italy. The clinical characteristics of all the COVID-19 patients hospitalised in the early days of the epidemic (21 February -19 March 2020) were recorded upon admission, and the time-dependent probability of death was evaluated using the Kaplan-Meier method (censored as of 20 April 2020). Cox proportional hazard models were used to assess the factors independently associated with the risk of death. Forty-eight (20.6 %) of the 233 patients followed up for a median of 40 days (interquartile range 33-47) died during the follow-up. Most were males (69.1 %) and their median age was 61 years (IQR 50-72). The time-dependent probability of death was 19.7 % (95 % CI 14.6-24.9 %) 30 days after hospital admission. Age (adjusted hazard ratio [aHR] 2.08, 95 % CI 1.48-2.92 per ten years more) and obesity (aHR 3.04, 95 % CI 1.42-6.49) were independently associated with an increased risk of death, which was also associated with critical disease (aHR 8.26, 95 % CI 1.41-48.29), C-reactive protein levels (aHR 1.17, 95 % CI 1.02-1.35 per 50 mg/L more) and creatinine kinase levels above 185 U/L (aHR 2.58, 95 % CI 1.37-4.87) upon admission. Case-fatality rate of patients hospitalized with COVID-19 in the early days of the Italian epidemic was about 20 %. Our study adds evidence to the notion that older age, obesity and more advanced illness are factors associated to an increased risk of death among patients hospitalized with COVID-19. SN - 1096-1186 UR - https://www.unboundmedicine.com/medline/citation/32446978/30_day_mortality_in_patients_hospitalized_with_COVID_19_during_the_first_wave_of_the_Italian_epidemic:_A_prospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1043-6618(20)31239-1 DB - PRIME DP - Unbound Medicine ER -